Monday, November 16, 2009

My Baby's Birthday, and My HBAC Anniversary

Four years ago today, I gave birth to my youngest child Megan. It was a triumph on multiple levels, as I had a cesarean with my second child, and was told that I would surely kill Megan or die myself if I "attempted" a VBAC. You see, I am prone to having larger babies ( those of you who have met my husband understand, lol ), I was closed with a single layer of suturing instead of double after the cesarean, *and* I got pregnant with her less than a year after my cesarean. I was told that all of these lined up would mean certain uterine rupture. The OBs who had agreed to "let me try", all gave me a gestation limit of 40 weeks. They all said that it would be an automatic repeat cesarean if I got to that point with no signs of labor in sight. And if she was looking to be "too big", it would be an automatic repeat cesarean. Basically, if I looked at them funny it would be an automatic repeat cesarean. It took some women from ICAN ( International Cesarean Awareness Network ) to challenge by beliefs about childbirth, for me to even look in a different direction.

Like most people, I believed that doctors know best. After all, they go to medical school for years and years, and HAVE to know all there is to know. It took me a while to learn that Obstetricians are NOT trained in natural birth. Most go through their entire residency without seeing a single truly natural birth, with the exception of the mom who walks in ready to push ... and even then everyone freaks out. Obstetricians subscribe to the belief that childbirth is a pathology, not physiology. Now, there are certainly exceptions to the rule ... just as not everyone home birth Midwife is trusting of the birth process, or best for mom and baby. But it took me from the beginning of my pregnancy, until 33 weeks, of research to come to this epiphany.

If there is one thing that I can tell women who have had a cesarean, and were told that either their body failed them ( pelvis is too small, labor was too long, cervix didn't open enough, body got too tired ), or their baby failed them ( baby too big, baby didn't come soon enough ) ... is to research their butt off. Because it is so much easier for a care provider to tell a woman that her body didn't work right, rather than to admit that baby and body just weren't ready, or that he/she ( the care provider ) unnecessarily intervened in the process, causing it to spiral into the operating room.

At 33 weeks I started calling Midwives. I was turned down by many. I was starting to lose hope of giving my daughter a better birth, because I knew it wasn't going to happen in the hospital. I was down to one last name ... and thankfully, God had us matched perfectly. Brenda is an amazing Midwife who serves women who need it the most, especially when many others would turn them away. Without her, not only would I not have given Megan a better birth, but I also wouldn't be the Midwife I am today.

I will premise my birth story by saying that four years ago, I wasn't where I am now in my beliefs about birth. There are certainly a few things that I would do differently. I do NOT advocate castor oil inductions by any means. Nor do I advocate artificial rupture of membranes. At the time, having my midwife break my water was a blessing. I was starting to pass out. But in my own practice, I have not yet found a valid reason to break the bag of waters ... leaving things to occur naturally in their own timing.

I had been doing the yucky prodromal labor think for what felt like forever. I had almost 6 weeks of contractions that would get so regular and start getting more intense, that I was sure it was "it" a few times. Even had my poor midwife drive out here in the middle of the night which ended up being for nothing. I had regular contractions all through the night on the 10th and called Brenda at about 4am. She came and when she checked me at 8:30 or so, I was a mere 2cm and not effaced much. Megan was also floating high still. I was crushed. Jeramy had the day off and since his grandmother had come up to help with the kids, we decided to go walking that evening to see if it would help anything. I had horrible pressure on my cervix and ended up passing some bloody show. Nothing more though.

The pressure on my cervix changed to a stabbing pain anytime I was doing anything other than sitting, so on Monday the 14th we decided to go walk around a shopping center that is a mile around. The pain was awful, but I wasn't having any contractions at all. I asked Jeramy to stay home on Tuesday because of the pain, and to help around the house. That evening I decided to call Brenda to see if we could try castor oil in the morning. ( Added note: At the point of Megan’s birth, I wasn’t at the point where I really believed that birth was best left alone … I still had a LOT to learn! ) The pain was really awful, and I was having an incredibly hard time getting around after my kids and doing much of anything. I was also a week past my due date and more than a little miserable ( I know, bad reason to try castor oil...but I felt I couldn't take it anymore ).

Right after I got the go ahead from her for the cocktail in the morning, I used the restroom and had at least 3 tissues full of mucous. I called her back to give her the heads up, as I went into labor the same night I passed mucous like that with Noah. I decided to go to Walmart to get some laundry detergent and some needed things and then came home and took a shower. I had been having very small contractions on and off all day, but not much of anything. After the shower, I began having really strong contractions all of a sudden. I went in to lay down to see if they were staying...and they only got stronger. Stronger to the point where when Jeramy checked on me I was in tears. I said it was time to call Brenda. He wanted me to make sure it was really time so she didn't come out again for nothing. I assured him it was! Jeramy filled up the tub, which I went back and forth from because I kept getting too warm. She got here at about 1 or so...and by that time I had already told Jeramy I wasn't sure I could do it. The contractions were very intense and I couldn't imagine it just getting worse. I was also afraid of how far I had progressed...not wanting to hear 3cm or so. When Brenda checked me I was happy to find myself at 5, and she could actually stretch me to 6cm. I tried getting back into the tub, but only ended up getting too hot again. I decided to go lie down in bed to try to cope with everything. I did okay for a while, until things got REALLY intense, at which point I would lose it when a contraction peaked and start shaking my head hard saying I couldn't do it. Brenda was amazing in helping me relax through some of them, reminding me to relax my entire body and even asked if she could pray over me...which I welcomed gladly. Back labor was awful, and my poor husband tried applying counter pressure when I almost felt like I jumped out of my skin...it didn't feel good at all, it only intensified things. I got up and labored on the toilet for a bit which felt good for a while, but then let out a grunt when it felt good to bear down. This alarmed Brenda, and she and Jeramy got the bed prepared. They got the shower liner under the sheet and the chux pads out on the bed. She decided to check me again to see if I was complete, but I was only at 7-8cm. The pressure was awful and I felt like I was having one big contraction and was starting to feel like I was going to pass out, instead of breaks in between. After lots of discussion, we decided to go ahead and break my water, and that helped TREMENDOUSLY. I was able to relax and sleep in between contractions somehow. By this point I had gotten REALLY vocal and was having a hard time relaxing during contractions at all. I started feeling pushy again, and when checked I was complete with just a little lip. Brenda said if I was feeling the urge to push, she could help move the lip out of the way. I began pushing and that became an exhausting experience. When I would push, burning pain would radiate through my hips. It felt amazing once I was really pushing effectively, but at the beginning of each push it hurt horribly. I was really becoming exhausted, and Brenda had me change to a side-lying position to push which seemed to be helping, but still not as effective. She suggested the toilet again, but I didn't think I could get up to it. So I rolled over and got on hands and knees and tried that way. Now I was REALLY screaming that I couldn't do it...I was too tired. Jeramy and Brenda kept reassuring me that I could, but I really needed to push. I was the only one that could get her out, and I needed to do it now. I ended up pushing more in a sitting/squatting position and even bit poor Jeramy's hand during one big push. Megan started crowning and I had never felt a burning sensation like that in my life. I was sure everything was going to split wide open. I remember the feeling of Brenda stretching me to keep me from tearing, hurting pretty badly as well. But getting her head out was the hardest. Brenda kept telling me I needed to push through the burning and get her out now, as she had been in that spot for a while and her head was kind of stuck behind my pubic bone. Megan was also going back up in between pushes because I couldn't hold it. So I pushed through the burning and felt her head come out, and then very quickly the rest of her slid right out. It was an amazing feeling.

I relaxed my entire body, still in that squatting position, onto the pillows in front of me. My hair was soaked with sweat and I was exhausted beyond belief, and also incredibly relieved that she was out. I smiled up at my husband and told him that I could feel her kicking against my thighs. They had me roll over, and Jeramy got to hand her to me, but had to be careful since the cord was short. She was beautiful. The first thing I noticed was how long her fingers were. She was so calm and alert. Jeramy was beaming and told me I did it and how proud he was of me. We waited for the cord to stop pulsating and then Brenda clamped and Jeramy cut. I spent some time admiring her, and then Jeramy took Megan out to the livingroom to meet her brother and sister and great grandma so that I could deliver the placenta. It wasn't hard at all, I just pushed and it came out easily. That also felt really good to get out. I was still burning quite a bit, but was laying back and relaxing knowing that the hard work was done.

Jeramy came back in with Megan, and I latched her on to nurse. She latched on immediately and did so very well. I asked if we could weigh her and get measurements...I was so anxious to see! When Megan was born, Brenda said she thought she was a good 8 1/2-9 lbs. Well, Jeramy was the one to weigh her, and he got wide eyed and asked Brenda if what he was seeing was correct. She looked at the scale and got the same look on her face! He then announced 10 lbs 10 ounces and I couldn't believe it. Furthermore, I couldn't believe when Brenda measured her and she was 23 inches long. I knew my belly had been huge, but never imagined she'd come near to 11 pounds. Jeramy went out and announced it to his grandma, who couldn't believe it either.

Brenda checked me for tears, and said it looked like I had one up towards my labia, and then one on my perenium and she could sew me up after I got cleaned up and showered. I tried twice to get up and shower, but while sitting on the toilet I almost passed out after the burning from peeing. So I was sent back to bed until I could get some fluids in and some toast. When I did take a quick shower and get back into bed a few hours after Megan was born, Brenda checked me to find that by me laying with legs together for so long, I was already starting to heal naturally. She had to really look for the tear she found before on my perenium, and she said there were only a few slits up towards my labia from the skin stretching, and those would heal on their own. As for the perenium, she numbed me, which didn't take too well...and I cried through the single stitch she put in. She said one would be enough along with me keeping my legs closed for a while. I was relieved not to have to endure another stitch. She gave me my instructions and a big hug and kiss and left us to our new family.

Recovery has been amazingly fast in comparison to both my previous vaginal birth, and the cesarean. It's amazing how things work perfectly when done naturally. My system didn't have to get over any drugs being pumped into me, or soreness from an episiotomy and stitches. Compared to a lot of homebirth stories I have read, I didn't feel mine went as smoothly, and I definitely didn't cry out that I would do it again after all was said and done...but it WAS beautiful. It was beautiful that my baby was handled gently at birth, not rubbed down and tagged with plastic and handed from one unfamiliar hand to another. She was treated peacefully and gently, and for that alone I would go through the pain all over again.